Juneteenth: Acknowledging the Past and Committing to the Future
This piece was corrected on June 20, 2023. The Senate budget leaves in place a provision that would increase pay for care workers.
Tanisha Pruitt, PhD | Bree Easterling
Juneteenth, often celebrated on June 19th, commemorates the day the last enslaved Black Americans were released from slavery. This joyous moment took place in Galveston, Texas more than two years after President Lincoln signed the Emancipation Proclamation. Juneteenth reminds us of our shared responsibility to recognize the legacy of slavery, acknowledge its deep impacts on the lives of Black people, and build racial equity into our public policy.
Throughout Ohio’s history, lawmakers have created polices that harm Black people, families and communities, often by neglecting to fund or equitably draft policies that affect the social determinants of health. Access to good schools, nutritious food, safe housing and clean air all contribute to a healthy life. Policies such as redlining, regressive taxation and inequitable school funding cut off that access. Those policies are racially biased, even when and sometimes because they are race neutral on the surface. As a result, they disproportionately harm Black people, doing long-lasting harm to the physical and mental health of individuals and entire communities.
In fact, Black Ohioans experience worse health outcomes than any other racial group that has sufficient data collected. Compared to their white counterparts, Black Ohioans are more likely to die before the age of 75, Black babies are more than twice as likely to die before their first birthday, and Black mothers are more than twice as likely to die while giving birth. Black Ohioans are more likely to die from heart disease, stroke, diabetes, cancer and chronic kidney disease — and they experience chronic diseases at higher rates.
In Ohio, COVID-19, initially hit Black Ohioans much harder, even prompting Governor DeWine to create a taskforce. Misinformation and politicization of masking and vaccination drove death rates disproportionately high for white Ohioans as the pandemic progressed. COVID-19 can have long term health consequences, and as the Cleveland Plain Dealer noted, “Being Black and healthy is harder than ever post-COVID-19.” The article notes that health gaps between Black people and white people widened after COVID. A 2022 study co-authored by researchers from Cleveland’s Case Western Reserve University and published by Mayo Clinic Proceedings compared the number of deaths from cardiovascular disease (CVD) prior to and post-COVID. The study found that CVD deaths during the pandemic jumped by 13.8% for Black patients, compared to a 5.1% increase for white patients, which according to the Plain Dealer possibly erased gains that were two decades in the making.
The Ohio Department of Health estimates (as do others) that social determinants account for as much as 80% of health outcomes. That means the disparities described above are in large part due to systemic disadvantages Black Ohioans face — which are created and maintained by public policy choices. These choices are part of what we call structural racism, and their effects are compounded by discriminatory beliefs and practices, violence, toxic stress and inequitable access to resources, including medical care and services.
In a 2022 survey by the Pew Research Center, Black Americans were asked why they thought Black people in the U.S. experience worse health outcomes than other racial groups. Sixty-three percent said one “major reason” was “less access to quality medical care where they live.” Fifty-two percent said environmental problems in their communities were a major factor, and 49% said that health care providers being unlikely to give advanced care was a major reason for the disparities.
For young Black trans and nonbinary Ohioans, racially biased policies overlap with anti-trans policies, compounding the harm. Mental health data make this especially clear: Within the past year, 25% of Black transgender and nonbinary young people nationwide reported attempting suicide at least once, and in general have higher rates of depression, anxiety and suicidal ideation than even their cisgender Black LGBQ counterparts. This is at least in part the result of inadequate access to health care that meets their unique needs. Ohio legislators are attempting to reduce access even more, attacking LGBTQ+ youth, with bills such as HB 68, which would create legal barriers to gender affirming care for young Ohioans. HB 68 and similar anti-trans legislation will send shockwaves through Ohio’s LGBTQ+ communities, and disproportionately harm Black Ohioans for all the reasons we describe above.
This week, the Ohio Senate passed yet another harmful budget bill that will cost the state nearly a billion dollars each year for tax cuts that mostly benefit the wealthy. The Senate’s budget completely fails to address maternal and infant mortality, for which Black mothers and babies are at disproportionate risk. It cuts support for school lunches and food banks and exacerbates barriers to basic health and economic security supports — the kinds of policies that can help reduce racial health disparities.
To ensure Ohio is the best state for all, we must demand lawmakers pass budget and policy solutions that improve health, economic security, and safety for Black people. Raising the minimum wage to $15 would shrink the pay gap between Black workers and their white counterparts — as would eliminating policies that impede union organizing. Repealing HB 68 and increasing Medicaid eligibility would allow more Black Ohioans to access the health care they need. Eliminating discriminatory collateral sanctions, and implementing sentencing policies and state standards for culturally competent policing would keep Black Ohioans in their beloved communities and out of prison.
If Ohio is to be a state where all people can live well, we must reckon with the historic harm of race-based legislation and address the wide, long-standing policy gaps that create and intensify the disparities faced by Black Ohioans. Until that happens, Juneteenth is a day that simply recognizes the Emancipation Proclamation, a day that reflects freedom in theory, rather than a step closer to liberation in practice.
 The preceding data are from Health Policy Institute of Ohio’s 2023 Health Value Dashboard.